Our overall goal is to develop methods to study the turnover of neutrophils in patients with acute leukemia and other malignancies to detect pathophysiologic abnormalities which may cause neutropenia. As a major prior accomplishment, we have developed a test involving the exposure of a patient's own heparinized blood to the cellophane of a hemodialysis coil followed by reinfusion of this blood to produce a transient neutrophilia. This coil test is doubly useful. The magnitude of the neutrophilia is proportional to the marrow neutrophil reserves as defined by the mature neutrophil cellularity of a marrow specimen. The fall-off of the neutrophil count from the peak back to baseline is the same as the DF32P-measured neutrophil survival. Short neutrophil survival may be detected as readily by the coil test as by the much more complex DF32P test. We are proposing simplification of the coil test by putting the cellophane into a blood bag. Currently we are testing various models of the preliminary bags in dogs. We are also gathering information regarding how much cellophane is needed, how long exposure to cellophane is needed, how much blood is needed as a minimum, and what is the biochemical basis for these changes. This seems to involve activation of the alternate complement pathway. We will comare the coil and/or bag test along with other tests for marrow neutrophil reserves with a new, more precise method for quantitating the total marrow mature neutrophils in order to find out which of the simple tests is most reliable. We will test patients on chemotherapy to see if the coil test can more reliably than the white blood count predict future marrow toxicity by drugs. In the same patients we will test for antineutrophil antibodies using DFP labeled neutrophils from patients with paroxysmal nocturnal hemoglobinuria, a test which we developed. We will also test the same patients' bone marrows with the soft-agar colony growth technique for correlations with the studies of peripheral turnover of neutrophils. Ultimately we hope to demostrate whether cancer patients can actually survive longer due to the use of these tests. Studies are being designed to test this. BIBLIOGRAPHIC REFERENCES: 1. Carmel, R., Coltman C.A., Jr., and Brubaker, L.H: Serum Vitamin B-12 Binding Proteins in Various Neutropenic States. Proc. Soc. Exp. Biol. Med., 148: 1217, 1975.